Global Health 2014 – Making Progress in a Fragile World

As we end 2013 and look toward 2014 in global health, we’re reminded that the world is a very fragile place.

Mosquitoes known to carry Dengue fever have been detected in California, for example, raising concerns among public health officials.

Following in the wake of the Philippines typhoon, debilitating and potentially fatal diseases now threaten the country Syria's bloody civil war has triggered an outbreak of polio.

And malaria cases in the United States have reached a 40-year high, according to the Centers for Disease Control and Prevention. While all were travelers who were infected overseas, this underscores the fact that diseases are not limited by borders and can travel across the world in just hours.

These current challenges to humanity are serious; but so are the needs for new funding that will help us plant and sustain research seeds and develop new products to head off future global health crises.

Indeed, the sad truth for those of us in global health today is that the financial pressures rival the scientific stresses we encounter as we try to help those who are afflicted with disease, or at risk of contracting disease.

The good news is that this economic squeeze will continue to shape a series of unique and fruitful global health collaborations in 2014.

To develop a vaccine to fight a potential H5N1 flu epidemic, for instance, IDRI recently contributed adjuvant compounds to a joint venture that included a Canadian company, which created proteins from tobacco leaves, and an Israeli company, which developed micro-technology for needleless injections. A Phase I clinical trial shows positive interim results for this vaccine candidate.

Funded by the Defense Advanced Research Projects Agency (DARPA), the objective of this global partnership was to come up with a flu vaccine that could be sent through the mail and then self-administered if an epidemic arises. The innovative approach was intended to help people avoid leaving their homes and going to health centers to seek a vaccine, putting themselves and others at further risk.

Adjuvants – which trigger and enhance the immune response in order to boost vaccine effectiveness, versatility and reach – are leading us to vaccines that can protect people against a broad range of viruses.

In the case of leprosy, however, a vaccine just isn’t enough.

Leprosy was reported in a number of countries over the past year, and it has surfaced in Africa, Asia and South America. The disease’s symptoms – which include progressive and permanent damage to the skin, nerves, limbs and eyes – can take several years to appear. This makes diagnosis at an early stage very difficult. And that’s one of the reasons why there are more than 250,000 new cases of leprosy every year, and why many more cases go undetected.

To help address this issue, IDRI has been working on a rapid and easy-to-use diagnostic test that detects leprosy infection up to one year before clinical symptoms occur.

This test has now been approved for use in Brazil. As part of the overall surveillance campaign, a second diagnostic test for leprosy – one that detects T-cells, a signal that the disease is imminent and needs to be treated – has also been developed. IDRI’s work in diagnostics can aid in early detection of leprosy infection, but our scientists are also focused on developing a vaccine that would prevent the disease and provide long-term protection for those who are most at risk. The objective in 2014 is to scale up and advance our leprosy vaccine efforts in the clinic.

The bottom line is clear, though: once we have a test to diagnose leprosy, drugs to treat it, and a vaccine to prevent it, we will finally have the tools to bring an end to this devastating disease.

The quest to eradicate tuberculosis (TB) around the world will continue in 2014, too.And with good reason.

TB kills more people than any other infectious disease except HIV; it costs the global economy an estimated $1 billion every day; and there are nine million new cases each year.

But even worse, an increasing number of diagnosed multidrug-resistant TB cases are making the disease more difficult to control and multiplying the cost and time it takes to treat patients.

In response, IDRI is developing a new vaccine for tuberculosis. The vaccine has successfully completed safety trials and will now be tested in South Africa. In parallel, our scientists will continue to work on a new TB vaccine for therapeutic use – a solution that would treat, rather than prevent, the disease.

An effective TB vaccine for adolescents and adults would be the single most cost-effective intervention against tuberculosis. The currently available TB vaccine, developed 90 years ago, reduces the risk of severe forms of TB in early childhood but has been ineffective in controlling the global TB epidemic despite widespread use.

Finally, the global health community will persist in its efforts to keep the world’s animals well in 2014 through vaccination. Healthy animals mean healthier people, a stronger economy, and an improved quality of life on virtually every continent. Making measurable progress as we seek to achieve these three essential goals must remain our prime objective in the coming year.

IDRI bridges knowledge and action as it addresses the most intractable health challenges around the world. The 20-year-old organization’s unique product-based approach to fighting infectious diseases has already yielded a host of novel solutions that are protecting and saving lives. With deep relationships in the academic and corporate arenas, IDRI is working to create additional diagnostics, drugs and vaccines that will help those who need it most.